Radiology Teaching Files > Case 10093144

Contributed by: Rolando Reyna, Radiologist, Hospital Santo Tomas, Panama.
Patient: 30 year old female
History: burning ache  in the upper abdomen for 3 mo.

Fig. 1: upper GI series shows a thick folds of the stomach mucosa
Findings: barium series shows thickening of the stomach mucosa folds in the major curvature.
Discussion: Gastritis is an inflammation, irritation or erosion of the stomach mucosa. Gastritis is not one disease but a group of conditions, which are characterized by inflammation of the lining of the stomach. Gastritis can broadly be divided into acute gastritis and chronic gastritis.

Chronic nonspecific gastritis is not a single entity but a multifactorial disorder with ongoing injury to the gastric mucosa leading to chronic inflammation and gastric atrophy. Causes include hyperacidity, bile reflux, autoimmunity, and infection with H pylori.

Chronic nonspecific gastritis is of two types, dependent on the gastric distribution. Type A gastritis involves the fundic region and may extend to the gastric body. Autoimmune atrophy related to antibodies against parietal cells, as in pernicious anemia, has been called type A disease, whereas the multifocal atrophic variety has been labeled type B. This type of gastritis involves the antral zone and is related to acid-peptic disease of H pylori origin.
Chronic nonspecific gastritis may be further subclassified as superficial or atrophic gastritis, according to the depth of inflammation; however, these terms may cause more confusion than clarification.

Radiologic findings are often normal in this disorder. With more severe atrophic gastritis, a decrease in number or an absence of rugal folds ("bald fundus") occurs in the upper stomach. The contour of the stomach may become more tubular, with a distended fundus ("H-bomb sign"). Also, the folds along the greater curvature may become thin and crenated, and areae gastricae may be reduced in number and size.

In general, the radiologic signs on a UGI study that suggest the diagnosis of gastritis have been nonspecific and often conflicting; these include (1) fold thickening; (2) loss of rugal folds; (3) contour and caliber changes; (4) antral alterations, such as narrowing; and (5) nodulation or erosions.
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Additional Details:

Case Number: 10093144Last Updated: 08-12-2007
Anatomy: Gastrointestinal (GI)   Pathology: Non-Infectious Inflammatory Disease
Modality: Conventional RadiographAccess Level: Readable by all users
Keywords: gastritis

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